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CE Connection


A review

Author Information
doi: 10.1097/01.NPR.0000684264.14959.31
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INSTRUCTIONS Dysphagia: A review


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Dysphagia: A review

General Purpose: To provide a review of information addressing the pathophysiology, diagnostic studies, and recommendations for managing oropharyngeal and esophageal dysphagia. Learning Objectives/Outcomes: After completing this continuing-education activity, you should be able to: 1. Compare and contrast signs and symptoms, associated comorbidities, and pathophysiology of oropharyngeal and esophageal dysphagia. 2. Identify testing, imaging, and procedures used to diagnose dysphagia, and management strategies recommended for treating patients with dysphagia.

  1. Which of the following symptoms is consistent with oropharyngeal dysphagia?
    1. impaction
    2. nasal regurgitation
    3. acid regurgitation
  2. Esophageal dysphagia is associated with
    1. nasal regurgitation.
    2. the symptom of heartburn.
    3. symptoms that occur before the swallow.
  3. Globus is a benign condition that
    1. is a sensation of a lump in the throat.
    2. only occurs while someone is eating or drinking.
    3. involves symptoms of reflux such as acid/food regurgitation.
  4. Oropharyngeal dysphagia occurs in patients with
    1. Schatzki ring.
    2. “steakhouse syndrome.”
    3. neuromuscular disorders.
  5. Approximately what percentage of patients experience dysphagia after a stroke?
    1. 20% to 25%
    2. 37% to 55%
    3. 60% to 75%
  6. The authors describe nonclassic symptoms associated with esophageal dysphagia that includes
    1. hoarseness.
    2. complaints of globus.
    3. trouble initiating the swallow.
  7. An expedited evaluation is recommended by the author to rule out an underlying malignancy for a patient who presents with
    1. weight gain.
    2. odynophagia.
    3. increased appetite.
  8. Patients with scleroderma are at risk for
    1. oropharyngeal dysphagia.
    2. esophageal motility disorders.
    3. an allergic etiology for dysphagia.
  9. A Schatzki ring occurs due to esophageal
    1. dilation from “sigmoid esophagus.”
    2. tapering at the LES.
    3. narrowing from inflamed esophageal mucosa that forms scar tissue.
  10. Esophageal strictures can develop in patients with
    1. Crohn disease.
    2. chronic obstructive pulmonary disease.
    3. long-term nasogastric feeding tube placement.
  11. Martin and colleagues provide information that EoE
    1. is most common in Black females.
    2. affects females-to-males at a ratio of 3:1.
    3. commonly co-occurs in children with a history of other atopic conditions.
  12. Achalasia is characterized by
    1. four subtypes.
    2. the absence of peristalsis.
    3. LES hypotension.
  13. The gold standard for diagnosing oropharyngeal dysphagia is
    1. a videofluoroscopic swallowing study.
    2. FEES.
    3. pharyngoesophageal high-resolution manometry.
  14. Bill and colleagues identify the preferred initial diagnostic test for evaluating a patient for esophageal dysphagia is a (an)
    1. EGD.
    2. high-resolution esophageal manometry.
    3. EndoFLIP.
  15. Screening for achalasia characteristics with a standard barium swallow can reveal a “bird's beak sign” that indicates presence of
    1. esophageal constriction.
    2. rapid passage of barium contrast.
    3. tapering at the LES.
  16. How many eosinophils per HPF within the squamous epithelium of the esophagus are needed at any level for a diagnosis of EoE?
    1. 5 eosinophils per HPF
    2. 10 eosinophils per HPF
    3. 15 eosinophils per HPF
  17. What is the gold standard for the diagnosis of primary motility disorders?
    1. EndoFLIP
    2. standard barium swallow
    3. high-resolution esophageal manometry
  18. The authors note that dysphagia in the setting of GERD often resolves with the use of
    1. antacids.
    2. H2 blockers.
    3. PPI.
  19. After starting treatment with PPI therapy for EoE, a patient is considered to be in remission if the diagnostic amount of eosinophilia resolves after
    1. 3 weeks.
    2. 5 weeks.
    3. 8 weeks.
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